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Individual

PUJA J BHAKTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
430 MAIN ST, GREEN BAY, WI 54301-5115
(920) 431-0345
Mailing address
11711 W BURLEIGH ST, WAUWATOSA, WI 53222-3196
(414) 771-2345

Taxonomy

Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
1001499
WI

Other

Enumeration date
03/02/2015
Last updated
08/28/2023
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